Leprosy and HIV Coinfection: A Clinical, Pathological, Immunological, and Therapeutic Study of a Cohort from a Brazilian Referral Center for Infectious Diseases

Talhari, Carolina; Mira, Marcelo Távora; Massone, Cesare; Braga, Andréa Arantes; Chrusciak‐Talhari, Anette; Santos, M.E.S.B.; Orsi, Ana Tereza; Matsuo, Christiane; Rabelo, Renata Fernandes; Nogueira, Lisiane; Ferreira, Luíz Carlos de Lima; Ribeiro‐Rodrigues, Rodrigo; Talhari, Sinésio

doi:10.1086/653839

Cited by 42 publications

(40 citation statements)

References 27 publications

(43 reference statements)

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“…Patients aged between 20 and 34 years accounted for the largest share (55%) of new AIDS cases, followed by the 35-to 49-year age group (33%) and the 15-to 19-year age group (3%). Overall, the age distribution of AIDS case reports among women was similar to the distribution among men, except for the youngest age group (13)(14)(15)(16)(17)(18)(19) Figure 4). Considering that all municipalities reported equally, Manaus is the most affected city, with 86.7% of AIDS cases, followed by Parintins (2.3%), Itacoatiara (1.5%), and Tabatinga (0.1%).…”

Section: Transmission Patternsmentioning

confidence: 64%

“…At a reference hospital in Manaus, 46.8% of patients with AIDS had positive cultures for Mycobacterium tuberculosis, and 9.3% had positive cultures for non-tuberculosis mycobacteria (10) . HIV/AIDS patients attended at the same reference hospital displayed a prevalence of coinfection with chronic hepatitis B carriage of 6.4% (11) , a hepatitis B past infection rate of 40.2% (11) , a hepatitis C infection rate of 4.42% (12) , a leprosy infection rate of 0.76% (13) , and an anal squamous intraepithelial lesion rate of 38.3% (14) .…”

Section: The Early Years Of the Hiv/aids Epidemic In The State Of Amamentioning

confidence: 99%

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HIV/AIDS epidemic in the State of Amazonas: characteristics and trends from 2001 to 2012

Oliveira

Benzaken

Saraceni

et al. 2015

Rev. Soc. Bras. Med. Trop.

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70www.scielo.br/rsbmt I www.rsbmt.org.br Revista da Sociedade Brasileira de Medicina Tropical 48(Suppl I):70-78, 2015http://dx.doi. org/10.1590/0037-8682-0121-2013 Review Article ABSTRACT A scoping review was conducted to describe the epidemiological characteristics of the human immunodefi ciency virus/acquired immunodefi ciency syndrome (HIV/AIDS) epidemic in the State of Amazonas, Brazil, from 2001 to 2012, and temporary patterns were estimated from surveillance data. The results suggest that in its third decade, the Amazon HIV/AIDS epidemic is far from being stabilized and displays rising AIDS incidence and mortality rates and late diagnoses. The data suggest that AIDS cases are hitting mostly young adults and have recently shifted toward men, both homosexual and heterosexual. AIDS cases among the indigenous people have remained stable and low. However, the epidemic has disseminated to the interior of the state, which adds diffi culties to its control, given the geographical isolation, logistical barriers, and culturally and ethnically diverse population. Antiretroviral (ARV) therapy has been decentralized, but peripheral ARV services are still insuffi cient and too distant from people who need them. Recently, the expansion of point-of-care (POC) rapid HIV testing has been contributing to overcoming logistical barriers. Other new POC devices, such as the PIMA CD4 analyzer, will bring the laboratory to the patient. AIDS uniquely coexists with other tropical infections, sharing their epidemiological profi les. The increased demand for HIV/AIDS care services can only be satisfi ed through increased decentralization to peripheral health units, which can also naturally integrate care with other tropical infections and can promote a shift from vertical to integrated programming. Future challenges involve building surveillance data on HIV case notifi cation and covering the spectrum of engagement in care, including adherence to treatment and follow-up loss.

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Section: Transmission Patternsmentioning

confidence: 64%

Section: The Early Years Of the Hiv/aids Epidemic In The State Of Amamentioning

confidence: 99%

HIV/AIDS epidemic in the State of Amazonas: characteristics and trends from 2001 to 2012

Oliveira

Benzaken

Saraceni

et al. 2015

Rev. Soc. Bras. Med. Trop.

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“…Considering that the institution where the study was conducted (Institute of Tropical Medicine) is a referral centre for both diseases, it is possible that the 25 cases of leprosy and HIV coinfection out of a total of 3,290 HIV-positive individuals reported between 1996-June 2009 (SINAN 2009) represent the closest estimate of the prevalence of this coinfection in a major Brazilian city. Since the prevalence of leprosy in the state of Amazonas was 2.92/10,000 in 2008, these data clearly indicates a higher Hansen's disease prevalence among HIV-positive individuals when compared to the general population (Talhari 2010).…”

Section: Hansen's Disease Elimination and Human Immunodeficiency Virumentioning

confidence: 85%

Hansen's disease: a vanishing disease?

Talhari¹,

Grossi²,

Oliveira³

et al. 2012

Mem. Inst. Oswaldo Cruz

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The introduction, implementation, successes and failures of multidrug therapy (MDT) in all Hansen's disease endemic countries are discussed in this paper. The high efficacy of leprosy treatment with MDT and the global reduction of prevalence led the World Health Organization, in 1991, to establish the goal of elimination of Hansen's disease (less than 1 patient per 10,000 inhabitants) to be accomplished by the year 2000. Brazil, Nepal and East Timor are among the few countries that didn't reach the elimination goal by the year 2000 or even 2005. The implications of these aspects are highlighted in this paper. Current data from endemic and previously endemic countries that carry a regular leprosy control programme show that the important fall in prevalence was not followed by the reduction of the incidence. This means that transmission of Mycobacterium leprae is still an issue. It is reasonable to conclude that we are still far from the most important goal of Hansen's disease control: the interruption of transmission and reduction of incidence. It is necessary to emphasize to health managers the need of keeping Hansen's disease control activities to better develop control programmes in the future. The recent international proposal to interrupt the transmission of leprosy by the year 2020 seems to unrealistic and it is discussed in this paper. The possibility of epidemiological impact related to the human immunodeficiency virus/Hansen's disease coinfection is also considered

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“…2 Infeksi HIV dan bentuk klinis penyakit lepra pada awalnya diperkirakan akan menyebabkan pasien lepra berkembang ke arah tipe lepromatosa. Tipe lepra yang dilaporkan pada pasien ko-infeksi dengan HIV pada 2 studi dari Afrika Barat awal 90-an melaporkan peningkatan kasus MB 3 , sebaliknya sebuah studi di Brazil melaporkan kasus PB yang lebih dominan 4,14 , serupa dengan penelitian observasional besar yang dilaporkan dari Brazil oleh Sarno dkk, tentang ko-infeksi lepra dan HIV. Penelitian tersebut mengungkapkan pada pasien koinfeksi, lepra tuberkuloid adalah bentuk yang paling dominan dengan 78% pasien HIV ko-infeksi dengan lepra tipe PB dibandingkan dengan distribusi yang lebih seimbang antara lepra bentuk PB (50,6%) vs the MB (49,4%) di antara pasien lepra dengan HIV negatif.…”

Section: Ko-infeksi Hiv Dan M Lepraeunclassified

Ko-infeksi Human Immunodeficiency Virus (HIV) dengan Mycobacterium leprae

Anggraini¹

2017

JIK

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Human immunodefficiency virus (HIV) epidemic covers several countries with endemic leprosy without any significantincrease in the number of patients co-infected with HIV and leprosy, so it can be concluded that HIV-positive does notincrease the risk of developing leprosy. Clinicopathological spectrum of leprosy patients who are co-infected withHIV is not changed. Leprosy may be attributed to the presence of immune recovery syndrome after the administrationof highly active antiretroviral therapy (HAART). Long-term incubation period and the low incidence of leprosy inpatients with HIV make prospective cohort or case-control studies on the prevalence of leprosy among a group of HIVpositive and HIV negative hardly possible to be performed. The benefit of this circumstance is the HIV pandemicdoes not become a nuisance of the effort to control leprosy. Further studies on the molecular pathogenesis of M.leprae and other mycobacterial can provide an understanding of the differences of the pathogenesis in patients withHIV infection.

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Leprosy and HIV Coinfection: A Clinical, Pathological, Immunological, and Therapeutic Study of a Cohort from a Brazilian Referral Center for Infectious Diseases

Abstract: Taken together, these new insights allow the proposition of a classification system that includes (1) leprosy and HIV true coinfection, (2) opportunistic leprosy disease, and (3) leprosy related to highly active antiretroviral therapy.

Cited by 42 publications

References 27 publications

HIV/AIDS epidemic in the State of Amazonas: characteristics and trends from 2001 to 2012

HIV/AIDS epidemic in the State of Amazonas: characteristics and trends from 2001 to 2012

Hansen's disease: a vanishing disease?

Ko-infeksi Human Immunodeficiency Virus (HIV) dengan Mycobacterium leprae

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